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Gender, age, and screening differences in individuals diagnosed with malignant melanoma in the United States

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TitleInfo
Title
Gender, age, and screening differences in individuals diagnosed with malignant melanoma in the United States
Name (type = personal)
NamePart (type = family)
Paddock
NamePart (type = given)
Lisa E.
NamePart (type = date)
1975-
DisplayForm
Lisa Paddock
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
Rhoads, MD, MPH
NamePart (type = given)
George G
DisplayForm
George G Rhoads, MD, MPH
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
chair
Name (type = personal)
NamePart (type = family)
Bandera, MD, PhD
NamePart (type = given)
Elisa V
DisplayForm
Elisa V Bandera, MD, PhD
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = personal)
NamePart (type = family)
Lu
NamePart (type = given)
Shou En
DisplayForm
Shou En Lu
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = personal)
NamePart (type = family)
Berwick
NamePart (type = given)
Marianne
DisplayForm
Marianne Berwick
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
outside member
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
Graduate School - New Brunswick
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
Genre (authority = ExL-Esploro)
ETD doctoral
OriginInfo
DateCreated (qualifier = exact)
2012
DateOther (qualifier = exact); (type = degree)
2012-10
CopyrightDate (qualifier = exact)
2012
Place
PlaceTerm (type = code)
xx
Language
LanguageTerm (authority = ISO639-2b); (type = code)
eng
Subject (authority = RUETD)
Topic
Public Health
Subject (authority = ETD-LCSH)
Topic
Melanoma--United States
Subject (authority = ETD-LCSH)
Topic
Medical screening--United States
Subject (authority = ETD-LCSH)
Topic
Children--Health and hygiene
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
RelatedItem (type = host)
TitleInfo
Title
Graduate School - New Brunswick Electronic Theses and Dissertations
Identifier (type = local)
rucore19991600001
Identifier
ETD_4284
Identifier (type = hdl)
http://hdl.rutgers.edu/1782.1/rucore10001600001.ETD.000066934
Identifier (type = doi)
doi:10.7282/T3R78D0B
PhysicalDescription
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electronic resource
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application/pdf
InternetMediaType
text/xml
Extent
xi, 142 p. : ill.
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = vita)
Includes vita
Note (type = statement of responsibility)
by Lisa E. Paddock
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
Abstract (type = abstract)
Melanoma is the rarest but most lethal form of skin cancer. This dissertation focuses on three salient issues in melanoma research –pediatric incidence, completeness of ascertainment in cancer registries, and the role of screening. Chapter 1 addresses melanoma incidence in children in whom 40-60% of melanoma cases may be initially misdiagnosed. The purpose was to examine differences between children/adolescents and adults in demographics and clinical characteristics of melanoma. Cases diagnosed from 1995-2008 were identified using the Cancer in North America (CINA) Deluxe database from the North American Association of Central Cancer Registries (NAACCR). Frequency distributions and incidence rates were tested for differences using chi square statistics, rate ratios, and annual percent change. Results show that children were diagnosed at later stages (x2 = 63.59; p<.0001) and were more likely to have thicker lesions (x2 = 22.3; p<0.0001) than adults. Questions are raised about the role of hormonal/reproductive factors contributing to age and gender differences. Because of the growing evidence for under-reporting of melanoma incidence we investigated this issue in New Jersey (Chapter 2). We surveyed dermatologists to identify why melanoma may be underestimated and to quantify the extent of reporting delay. We also estimated the missing melanoma cases using a capture-recapture analysis. Using log-linear models we approximated that 817 melanoma cases were missed annually, most likely from physicians and pathology labs. These estimates can be used to improve the accuracy of melanoma incidence rates and to make targeted adjustments for reporting. In Chapter 3 we examined long term melanoma survival rates for skin self-examiners (SSE), which is a useful and inexpensive screening method that has the potential to reduce the risk of advanced disease. Cases were diagnosed in 1987-1989, followed through 2007, and analyzed using competing risks (CR) analysis. Cumulative incidence functions and proportional hazards regression models were fitted. The cumulative incidence curves by SSE were not statistically different (p=0.32) for death due to melanoma in the presence of CR. Skin awareness (HR= 0.49, p=0.002) was associated negatively and thickness (HR= 1.21, p<0.001) was associated positively with melanoma death. Although we did not find a significant association between melanoma mortality and SSE, we have confirmed previous findings of a protective association with skin awareness.
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Paddock
GivenName
Lisa
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2012-09-25 16:56:44
AssociatedEntity
Name
Lisa Paddock
Role
Copyright holder
Affiliation
Rutgers University. Graduate School - New Brunswick
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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